Variation in radiation doses in paediatric cardiac catheterisation procedures

Abstract

Paediatric cardiac catheterisation involves diagnostic and therapeutic procedures that range from simple to complex and can subject paediatric patients to varying radiation doses. The study aims to determine the variation in entrance doses in patients in terms of dose-area product (DAP) values and to investigate the methods for optimising radiation protection. A total of 190 paediatric patients belonging to age groups 0, 1, 5 and 10 y who underwent diagnostic and six selected therapeutic procedures at King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia were included in the study. Therapeutic procedures include coarctation (COA), patent ductus arteriosus (PDA), radiofrequency ablation, pulmonary, embolisation and septostomy. Fluoroscopy and cine radiography were used in all procedures. Patient demography (weight, age, gender and height), radiographic technique factors, fluoroscopy and cine time, frame rate, and DAP values were taken from patients records. Effective doses for each procedure were estimated from the DAP values. The mean DAP per procedure were analysed for correlation with patient equivalent cylindrical diameter, weight, fluoroscopy time and number of frames. Factors influencing the variation in doses were investigated. Initial results show that PDA occlusion has the highest mean DAP value of 23.21 Gy-cm2, while the diagnostic and septostomy procedures have the lowest value of 7.77 and 6.95 Gy-cm2, respectively.

Pilot program on patient dosimetry in pediatric interventional cardiology in Chile

“…The results of this survey show that radiation doses have a very large range (see Table IV), as shown by other pediatric surveys. 7,9,[11][12][13][14][15] However, few papers 4,5,8,10,16 reported radiation dose values by age group, as shown in Table VII. In this summary of the median values of P ka , the values of our survey tend to be lower, probably derived from the awareness of cardiologists in the management of patient doses and the careful setting of the x-ray system for pediatric protocols.…”

“…3 The first step in managing the risks from ionizing radiation is to know the dose values imparted to the patients during the imaging procedures. Several papers have been published on patient dose values for pediatric cardiac procedures, [4][5][6][7][8][9][10][11][12][13][14][15][16] but there has not yet published papers on these procedures in Latin America.…”

Substantial radiation reduction in pediatric and adult congenital heart disease interventions with a novel X-ray imaging technology

“…Unfortunately, variability in patient size and procedure types, together with the different ways of reporting results in other studies makes comparison with literature very cumbersome. For example some authors have made an attempt of providing dose reference by classifying the population in standardized age groups [16], [34], [38], while others in weight groups [15], [39], [40], [41] or fluoroscopy time [42], [43]. Moreover, when making comparisons in terms of patient dose, procedure complexity should always be assessed.…”

Evaluation of a new very low dose imaging protocol: feasibility and impact on X-ray dose levels in electrophysiology procedures

“…18–23 Also the removal of the scatter grid, which resulted in poorer image quality, has been shown to reduce radiation by as much as two-fold. 24 …”